Provider Demographics
NPI:1043304892
Name:CROSSROADS COUNSELING, INC.
Entity type:Organization
Organization Name:CROSSROADS COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-7535
Mailing Address - Street 1:501 EAST THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701
Mailing Address - Country:US
Mailing Address - Phone:570-323-7535
Mailing Address - Fax:570-323-3790
Practice Address - Street 1:501 EAST THIRD STREET
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701
Practice Address - Country:US
Practice Address - Phone:570-323-7535
Practice Address - Fax:570-323-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA417017101YA0400X, 251K00000X, 251S00000X, 261Q00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251K00000XAgenciesPublic Health or Welfare
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007434200011Medicaid
PA999029OtherBLUE CROSS/BLUE SHIELD #
PA1007434200034Medicaid
PA1007434200005Medicaid
PA1007434200007Medicaid
PA1007434200008Medicaid